Annual meeting of coordinators

for CME activities

University of Vermont College of Medicine

Continuing Medical Education

April 3, 2012

Disclosures

• No relevant financial relationships to disclose

Cheung Wong, MD

Objectives of meeting

• UVM CME office– Staff– Undergoing Reaccreditation

• Decision to be announced March, 2013

• Recognize the efforts of CME coordinators in conducting CME accredited activities

• Review mechanism for planning, monitoring and evaluation of CME activities

UVM CME

• Cheung Wong, M.D.– Associate Dean for CME, UVM COM– Department of Obstetrics/Gynecology, FAHC– E-mail: cheung.wong@uvm.edu

Who are we?

• Terry Caron– Director of CME, UVM COM– Conference coordinator– E-mail: terry.caron@uvm.edu– Phone: 802-656-2292

UVM CMEWho are we?

• Mary Gagné– Regional Program Coordinator– Conference coordinator– E-mail: mary.gagne@uvm.edu– Phone: 802-656-2275

UVM CME

Who are we?

• Kate Martin– Conference Coordinator– E-mail: katherine.martin@uvm.edu– Phone: 802-656-8449

UVM CME

Who are we?

• Natalie Remillard– Conference Coordinator– E-mail: natalie.remillard@uvm.edu– Phone: 802-656-2292

UVM CME

Who are we?

• Karen Whitcomb– Regional Program Assistant– E-mail: karen.whitcomb@uvm.edu– Phone: 802-656-2292

UVM CME

Who are we?

• Deborah Rhea – Conference Assistant– E-mail: Deborah.rhea@uvm.edu– Phone: 802-656-2292

UVM CME

Who are we?

• Sheila Dooley– Conference Assistant– E-mail: sheila.dooley@uvm.edu– Phone: 802-656-2292

UVM CME

Who are we?

• Michele Morin– Conference Assistant– E-mail: michele.morin@uvm.edu– Phone: 802-656-2292

UVM CME

Who are we?

• Moira Delahanty – Business/Accounting Specialist– E-mail: Moira.delahanty@uvm.edu– Phone: 802-656-2292

UVM CME

Who are we?

How should we communicate?

• Phone: 802-656-2292• E-mail: uvmcme@uvm.edu• Letter (CME office-Lakeside Avenue)• UVM CME web site

– http://cme.uvm.edu

• This meeting!

UVM CME activities• Postgraduate courses/seminars

– Directly sponsored– Jointly sponsored

• Regularly scheduled conferences– Grand rounds– M & M– Tumor boards– Lecture series

UVM CME

• Planning and implementation• Monitoring• Evaluation

Conducting CME activities

UVM CMEConducting CME activities

• Planning and implementation• Monitoring• Evaluation

UVM CME

• CME planning committee– Determines practice gaps/needs to be addressed– Sets goals and objectives to address the gaps/needs– Considers topics/formats appropriate to improving

physician competence/performance or pt outcomes

• Application forms• Disclosure forms• Commercial support form• Multiple speaker evaluation form

Planning & implementation of CME activity

Forms at : http://cme.uvm.edu

• Forms– Application forms

• Planning document • Checklist• Biographical data form

– Disclosure forms• Disclosure statement/attestation form• COI resolution form• Disclosure documentation form• Monitoring form

– Commercial support– Multiple speaker evaluation forms

UVM CMEPlanning & implementation of CME activity

Forms at : http://cme.uvm.edu

All forms have been revised.

http://cme.uvm.edu

UVM CME website-forms

UVM CME – Planning DocumentREVISED

Easier format

- check off boxes

- pdf instead of word doc.

- “walk you through” gap/need analysis

Some new info:

- barriers

- partners

- new evaluation choices

UVM CME – Biographical data form

• Forms– Application forms

• Planning document• Checklist• Biographical data form

– Disclosure forms• Disclosure statement/attestation form• COI resolution form• Disclosure documentation form• Monitoring form

– Commercial support form– Multiple speaker evaluation forms

UVM CMEPlanning & implementation of CME activity

Forms at : http://cme.uvm.edu

UVM CME – Disclosure/attestation formWho Discloses?

- Faculty

- Course Director

- Planning Committee

What needs to be disclosed?

Financial Relationship in the last 12 months with a commercial entity that provides healthcare products/services relevant to the topic of the presentation or series of presentations.

UVM CME – COI resolution form

UVM CME

• Planning and implementation• Monitoring• Evaluation

Conducting CME activities

• Forms– Application forms

• Planning document• Checklist• Biographical data form

– Disclosure forms• Disclosure statement/attestation form• COI resolution form• Disclosure documentation form• Monitoring form

– Commercial support– Multiple speaker evaluation forms

UVM CMEPlanning & implementation of CME activity

Forms at : http://cme.uvm.edu

UVM CME

• Goals & objectives of activity communicated to learners prior to activity

• Disclosure of sources of commercial support & relevant financial relationships from individuals controlling content (faculty and planners) made to learners prior to activity

• Relevant COIs resolved prior to activity• Completed disclosure documentation, COI, and

monitoring forms collected and sent to UVM CME office

Monitoring of CME activity

UVM CME – monitoring form

List Faculty

and

all planners.

Remember to post and sign!

(Disclosure can be “posted” via PPT slide. Attach slide

to signed form)

• Forms– Application forms

• Planning document• Checklist• Biographical data form

– Disclosure forms• Disclosure statement/attestation form• COI resolution form• Disclosure documentation form• Monitoring form

– Commercial support form– Multiple speaker evaluation forms

UVM CMEPlanning & implementation of CME activity

Forms at : http://cme.uvm.edu

UVM CME – commercial support form• List $ received and/or• In-Kind” contribution

– Non-monetary such as equipment, supplies, etc.

• Two signatures needed – Company Representative

– UVM CME

UVM CME

• Planning and implementation• Monitoring• Evaluation

Conducting CME activities

UVM CME

• Activity was evaluated in terms of effectiveness at meeting objectives

• Participants did not perceive commercial bias from the presentation

• Changes/improvements in practice will result from presentation

Evaluation of presentation

UVM CME – immediate post activity evaluation form

Affiliated/Jointly sponsored Grand Rounds

UVM CME

• Did the activity adequately address an identified professional gap and result in improved physician knowledge, performance, or patient outcomes?

• 3-4 month post-activity evaluation or chart audits, etc. (See planning doc for more options)

Evaluation of overall activity

3-4 Month Post Activity Survey(Sample)

• 1. Regarding the treatment of osteoarthritis, my care for these patients has changed based on information presented at the course.

• a. Yes• b. No• c. I do not see patients with this condition

 • 2. Based on what I learned at the course, I am now more likely to identify and

treat osteoarthritis patients with NSAIAs.• a. Yes• b. No

 • 3. The lecture on “XXX” has altered at least one aspect of my use of “Z” in my

practice.• a. Yes• b. No• c. I do not use “Z” in my practice

UVM CME – Planning document

Professional practice gap

• Definition: “The difference between actual and ideal performance or patient outcomes.”

Planning Doc -Practice gaps

• Examples:

1. Best/Ideal Practice: 100% of patients with osteoarthritis treated properly with NSAIAs. Current: Nationwide, only 20% of patients properly treated (AHRQ data).

2. Best/Ideal Practice: 0 Central Line Infections

Current: X Central Line Infections last year due to significant variation in techniques. (Internal Data)

3. Best/Ideal: All shoes with laces would be tied

Current: X% of providers have untied shoes (Observed)

Planning DocumentNeeds Analysis

BASED ON THE GAPS….

What do the learners need to know, be able to do, or perform? (Knowledge, competence, performance)

What strategy do they need to achieve “best practice”?

Planning Doc. - Needs Analysis

• Examples:

1. Providers need to understand the use of NSAIAs in treating osteoarthritis (Knowledge)

2. Providers need to become standardized in their approach to central line placement. (Performance)

3. Providers need to tie their shoes so that fewer people trip. (Performance)

Objectives

What can the learner expect to achieve by attending the lecture/event?

The participant should be able to…

1.1 …explain the use of NSAIAs in the treatment of osteoarthritis.

1.2 … determine when and how to properly use NSAIAs.

2.1 …discuss the need for a standardized approach in central line placement.

2.2 …successfully complete the standardized approach to central line placement.

3.1 …discuss the statistics of injuries associated with untied shoes.

3.2 …identify shoes that do not require laces.

Barriers (New)

What potential barrier might prevent participants from implementing their new knowledge?

Evaluation (Revised)

• Post Activity Evaluation – still required• 3-6 month measure of change still required but…

• Other options: chart audits, patient outcomes…• Or, you may still prefer to do a follow up survey.

Summary

• Activity planned by committee using multiple sources to identify gaps (QA, lit, evals)

• Objectives tied to gaps/needs• Course structured to address gaps• Evaluation

– Participants evaluated to assess change in knowledge and performance post activity

– QA data analyzed to assess impact of activity

Case examples

• Regularly scheduled conference• Tumor board

XYZ Hospital

• XYZ Hospital conducts a weekly tumor board• The activity has a CME planning committee,

comprised of a radiologist, a CME coordinator, an oncologist, a radiation therapist, a pathologist, and a surgeon

• The committee identifies 2 specific objectives for the activity based on identified gaps in physician knowledge, performance, or in patient outcome for lung cancer patients:

Planning & implementation of tumor board

XYZ Tumor Board

• 1. Reduce the time interval for patients from presentation to diagnosis– Average time = 28 days– Goal = < 14 days (national statistics)

• 2. Increase number of patients referred for minimally invasive treatment of lung CA– Emergence of thermal ablation techniques

(literature, annual ASCO meeting)

Objectives

XYZ tumor board

• The tumor board will track the following data for the year’s activity:– 1. Number of days between initial office visit

for chief complaint and tissue diagnosis for cancer patients

– 2. Number of patients referred to XYZ Hospital for thermal ablation of unresectable lung tumors

Planning & implementation of postgraduate course

XYZ tumor board

• Number of days between presentation and diagnosis of CA– 2012 = 35– Institute organizational measures to reduce this

• Patients referred for radiofrequency ablation of lung cancer– 2012 = 1– Create mechanism to refer to XYZ for RFA

Post activity evaluation

XYZ tumor board

• Planned by committee using multiple sources to identify gaps (QA, lit, meetings)

• Objectives tied to gaps

• Parameters of cancer patient care measured

• Changes implemented to improve on deficiencies in system

Common Mistakes• Planning committee (including Course

Director) does not make disclosure.

• Commercial support forms not completed.

• Monitoring forms – appropriate boxes not checked, forms not signed.

• Forget to evaluate 3-6 months post activity (by survey, chart audit, etc.)

Helpful Hints are listed on our website with the other forms!

Questions?